Seizure, epilepsy, convulsion, ketogenic,

Seizure Disorders: Electrical Storms

Seizure Disorders: Electrical Storms

The human brain is an awesome wonder. It is made of specialized cells, which are divided into two groups, neurons and glias. The average brain contains approximately 100 billion neurons and as many as a trillion glial cells.

Neurons are cells that transmit electrical impulses. There are many different types of neurons, but they have a similar structure. The portion of a neuron that contains the nucleus is called the soma. Arms called dendrites extend from the soma to make contact with surrounding neurons. A long arm called an axon carries electrical impulses to still other neurons. Axons can be hundreds or tens of thousands times longer than the diameter of the soma.

Glia means “glue” in Latin, as glial cells were once thought to be simply the glue that held neurons in place. It is now known that glial cells play many roles and are more properly categorized as partners of neurons. They facilitate the delivery of nutrients and oxygen to neurons and they actively participate in the process of transmitting signals between nerves by regulating the amount of neurotransmitting chemicals present in the space between neurons. Glial cells also act as insulators of neurons, much like the plastic covering of an electrical wire. Specialized glial cells destroy invaders and remove dead neurons.

Many chemicals are required for proper brain function. Serotonin is perhaps the most well-known brain chemical, as it is the target of many anti-depressant medications. Serotonin is but one of at least ten molecular transmitters, however. Some others include acetylcholine, norepinephrine, dopamine, GABA (gamma aminobutyric acid), and glutamic acid.

Over fifty peptides (combinations of two or more amino acids) that affect nerve activity have been discovered. Hormones are known to play roles in directing brain function. Even single ions, like zinc, affect the transmission of messages throughout the brain.

Incredibly, those billions of cells and hundreds of chemicals work in harmony to produce regular waves of electrical activity. The most commonly observed have been designated alpha, beta, gamma, delta, and theta waves. The type of waves seen vary by age, level of physical or mental activity, or stage of sleep.

This organized electrical activity defines life as we know it. Absence of electrical activity within the heart and brain indicates that life is no longer present. Lack of electrical waves within the brain is the more important of these two indicators. Absence of electrical activity in the heart indicates that death is imminent; absence of electrical activity in the brain indicates that all is lost. If administered within a few minutes an electrical shock can often jump-start a heart, but there is no resuscitative device available to restart a brain. An individual whose brain is no longer producing waves of electrical impulses may be able to be kept “alive” for a period of time by artificial means, but he or she will never again awaken or show any spontaneous sign of life.

Just as an absence of coordinated electrical activity is abnormal, so is the presence of excessive or uncoordinated electrical activity. The result of a burst of chaotic electrical activity is called a seizure. Seizures can produce a wide array of symptoms. Some cause a loss of consciousness, while others cause a momentary loss of unawareness of what is going on in the surrounding environment. Some cause a loss of voluntary muscle control; others may simply cause a person to smell an odor that is not actually present.

A seizure can be described as the result of an electrical storm within the brain. If the storm is localized, like an isolated shower, it results in what is called a partial seizure. If the storm is widespread, like a large thunderstorm or hurricane, it triggers what is referred to as a generalized seizure. Partial seizures are subdivided into two classes. Those that do not cause any decrease in consciousness are called simple seizures; those in which consciousness is impaired are classified as complex seizures.

A concept called seizure threshold is basic to understanding why seizures occur and how to best prevent them. Each individual has a maximum level at which controlled electrical activity can be maintained. That level is called the seizure threshold.

The seizure threshold can be likened to the boiling point of a liquid. The boiling point of water at sea level is 100 degrees Celsius (99.97 degrees to be precise). The boiling point of olive oil is much higher – 300 degrees Celsius, and that of acetone much lower – 50 degrees Celsius. Conditions, such as the amount of pressure present, affect the boiling point, giving water a boiling point of just 69 degrees Celsius.

People have different seizure thresholds, just as liquids have different boiling points. Anyone is capable of having a seizure, but one is more likely to occur in someone who has a low seizure threshold. Not only do seizure thresholds vary from person to person, but the seizure threshold of an individual will rise or fall depending upon factors such as the amount of rest obtained or the type of beverages consumed. Seizure prevention is accomplished by using various measures to increase the person’s seizure threshold.

Determining whether a seizure has occurred is not always an easy process. Simple fainting spells are much more common, and may be mistaken for seizures. Key signs and symptoms help to distinguish true seizures from fainting episodes. Generalized seizures are often preceded by an aura, such as a strange smell or a feeling of butterflies in the stomach. Urine or fecal incontinence often occurs during a seizure, but rarely in a fainting spell. Seizures are commonly followed by what is called a postictal state consisting of extreme drowsiness, headache, confusion, and often muscle soreness. Evidence of trauma, such as a bitten tongue, also supports the diagnosis of seizure.

When an individual experiences a seizure for the first time, a thorough search for a reversible underlying cause should be undertaken. None will be found in approximately 50 percent of individuals. In that case the seizure is said to have been idiopathic, a medical term that means, “We don’t have a clue why this occurred!” Most idiopathic seizure disorders first present in childhood, between the ages of two and fourteen.

Seizures that first develop in adulthood are more likely to have an identifiable cause. Generalized seizures are generally due to biochemical abnormalities. Partial seizures are more likely to be triggered by anatomic abnormalities such as tumors or scar tissue from traumatic head injuries or strokes.

When a seizure occurs, drugs should immediately be considered as a reversible cause. Illicit drugs including cocaine, amphetamine, heroin, and phencyclidine (PCP, Angel Dust) are known to trigger seizures and a wide array of over-the-counter and prescription drugs are also capable of doing so. If I were to list all of the legal drugs that have been reported to cause seizures the list would fill much of the remaining space in this letter.

The most likely to do so are cough and cold preparations, appetite suppressants, antidepressants, anti-psychotics, certain antibiotics, antifungal drugs, and asthma medications, but any drug should be considered a possible suspect when an individual experiences a seizure for the first time or when an epileptic reports an increase in seizure frequency. Several years ago a woman in her mid-twenties came to see me regarding her seizure disorder. Her first seizure had occurred two years earlier, when she was well beyond the age at which idiopathic seizure disorders generally present. Since she could not drive an automobile because of the risk of having a seizure while doing so, her independence and lifestyle had been severely compromised.

She had not experienced any head trauma, and scans of her brain had not shown any tumor or other lesion that could explain why she had begun to have seizures. She had, however, been placed on an antidepressant medication approximately six months before her first seizure. The drug had been prescribed because she had become despondent following the death of her father. The group of antidepressants that is most likely to trigger seizures is called tricyclics. Because she was taking a drug from a family called SSRIs, the possibility that the medication could be triggering her seizures had never been considered.

While seizures are not as common with the use of SSRIs, they do occur. Since the incident that had triggered her depression was well past and she had been doing well she was no longer in need of an antidepressant of any kind. I recommended that she stop the medication, and her seizures ceased.

At times it is not the presence of the drug, but withdrawal from it that triggers a seizure. This is particularly true of alcohol and tranquilizers. On many occasions I have been called to evaluate an individual who has presented with a seizure and learned that the episode occurred as he or she was in the process of sobering up following an alcohol binge.

Head trauma is a major cause of seizure disorders. One of my uncles struggled with seizures throughout the remainder of his life after falling from the upper bunk of a railway sleeping car as a young adult. Post traumatic seizures can present immediately after the injury or may first appear months later.

Any infection involving the central nervous system can cause seizures. Seizures can also be triggered by childhood vaccinations, primarily the DPT (although they are significantly less common since the introduction of acellular pertussis), and the MMR. Seizures associated with MMR immunizations are due to the measles component and typically occur 8 to 10 days following the vaccine’s administration.

Inflammatory conditions such as lupus erythematosis or vasculitis can trigger seizures. A seizure can be the first sign of a tumor or other lesion within the brain. While rare, seizures can also occur with multiple sclerosis.

When a reversible cause cannot be identified, a management plan should be instituted to control the frequency and severity of the seizures. Many anti-epileptic drugs are available, and they are often necessary. Optimum management of seizure disorders requires a multifold approach, however. Many individuals with seizure disorders are simply given a prescription for one or more anticonvulsant drugs. This is unfortunate, since seizure control is much more likely to be achieved when non-pharmaceutical measures are also instituted.

Supporting one’s general health is critical to seizure management. This is because virtually anything that adversely affects the body as a whole will also lower the seizure threshold. Loss of sleep, the onset of a cold, and hormonal changes as a menstrual period approaches are just a few of the physical stresses that can lower the seizure threshold. Something as simple as a rolling or flickering video screen can trigger a seizure in susceptible individuals. Emotional stress can also lower the seizure threshold.

Maintaining good hydration is important, but it is also necessary to replace body salts during times of intense physical activity. Athletes, particularly long distance runners, may experience a seizure if water is replaced without providing electrolytes as well. This is because salts, particularly sodium, are lost in perspiration. If water is replaced without an appropriate amount of sodium, the level of sodium in the bloodstream may fall to an unsafe level and a seizure may occur.

The diet should be as free of chemical additives and preservatives as possible. It has been reported that avoidance of food dyes and other chemical additives (the Feingold diet) can significantly decrease the frequency and severity of seizures.

Food additives most commonly reported to trigger seizures are tartrazine (FD&C Yellow # 5) and benzoic acid. Aspartame has also been reported to increase the risk of seizures.

Food sensitivities can lower the seizure threshold. The most commonly reported food sensitivities are cow’s milk, cheese, citrus fruits, and wheat. Avoidance of foods to which a person is sensitive can often bring a dramatic reduction in seizure occurrence and may reduce the dose of medication that is required for seizure control.

Alcohol, nicotine, and caffeine should be avoided. Alcohol abuse is believed to be the root cause of up to a fourth of new seizure disorders in adults. While some people with epilepsy do not notice any adverse effect from one or two cups of coffee daily, others are very sensitive to caffeine and unable to tolerate even small amounts.

Since drops in blood sugar can trigger seizures it is important to eat regularly, including some fat or protein with each meal or snack. Refined carbohydrates (cookies, candies,etc.) predispose to swings in blood sugar and should be consumed only as desert following a balanced meal, if at all.

When seizures are occurring frequently a diet that is very low in carbohydrates and high in fat, called a ketogenic diet, can bring about a dramatic improvement in some instances. Approximately one third of children placed on the ketogenic diet have a 90% reduction in seizures within the first year. Another third see a 50 – 90% reduction within a year, and the final third do not improve on the diet. Because the diet is very restrictive (nearly 90 % of the calories come from fat), many will not stay on it. The ketogenic diet must be carefully supervised, as it can cause side effects including nausea, vomiting, constipation, and loss of appetite. Poor growth, kidney stones, and abnormal heart rhythms have also been reported, as has impaired activity of white blood cells and platelets.

Because of the difficulties associated with following a traditional ketogenic diet, a modified Atkins diet has been tried, in which carbohydrate intake is severely limited, fat intake is encouraged, and protein can be eaten as desired. This approach has reduced seizure frequency by 50 % in up to 60 % of participants, but as many as a third of those who start the program drop out within the first 3 months.

Ketogenic diets have been most successful when used in children, particularly when the family is highly motivated due to the severity of the epileptic condition. Children with a rare condition called infantile spasms can experience seizures many times every day, giving a strong motivation to see that the diet is maintained.

Three functional factors appear to play a significant role in lowering seizure threshold. These are free radical damage, loss of methylation ability, and mitochondrial dysfunction. Free radical damage occurs when an unbalanced molecule attaches to a cell membrane or substance within the body. Loss of methylation ability occurs when the body runs short of molecules called methyl groups and the nutrients required to use them to repair damage within the body. Mitochondrial dysfunction is a state in which cells are not able to produce energy effectively. For a deeper explanation of these issues see the topics Antioxidants, Homocysteine, High, and Mitochondrial Support in the Wellness Clubs of America library.

Nutritional supplementation to support the seizure threshold should begin with a comprehensive vitamin, mineral, and amino acid formulation that will provide optimum levels of antioxidant nutrients along with other substances needed by the body for ongoing maintenance and repair activities. I personally use a product called Lifetime.

Under normal conditions, nutrients like vitamin E and vitamin C do not easily enter the brain, where they are needed to stop free radical activity that is lowering the seizure threshold. Fortunately, substances called oligoproanthocyanidins (OPCs) pass freely into the brain and carry other antioxidants with them when they do. Grape seed extract is rich in OPCs and is an excellent means of providing antioxidant protection to the central nervous system, including the brain. 100 mg. twice daily is recommended.

It has been known for many years that supplementation of magnesium and vitamin B6 results in improved seizure control. More recently it has been learned that this is due to the role these nutrients play in the body’s use of methyl groups for repair of cellular damage. When a source of methyl groups, such as dimethylglycine is provided along with magnesium and B6 an even greater benefit is seen. Activator is a formulation that provides these nutrients in combination. One to three capsules twice daily may be used.

Optimum mitochondrial support is provided by Second Wind, which I formulated specifically for that purpose. Two capsules two or three times daily should be taken.

Omega 3 oils are also beneficial in maintaining the highest possible seizure threshold. Two or three 1200 mg. capsules twice daily will provide optimum amounts of these essential fatty acids.

Seizure disorders need not be disabling. Applying sound health maintenance principles including eating well, obtaining adequate rest, avoiding alcohol, caffeine, and nicotine, and providing appropriate nutritional supports can dramatically decrease the amount of medication required for seizure control. This will minimize the number of adverse effects associated with drug treatment and maximize the individual’s quality of life.

© 2007 Wellness Clubs of


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